This was indeed a good and significant book.

Despite being just a little under 300 pages, which I don't think is overly long, it seemed to go on forever.

For me, the most crucial aspect I took away from it is that it prompts the medical community to seriously question their assumptions when dealing with a population that doesn't hold the same assumptions.

I gained a wealth of knowledge about the Hmong culture and shamanism.

Now, being an interpreter is a profession that requires courage, and so is this related field that involves understanding and working with different cultural beliefs and practices.

It makes one realize the importance of being open-minded and flexible in the medical field to provide the best care possible to all patients, regardless of their cultural backgrounds.

This book has truly opened my eyes and made me more aware of the complex issues that can arise when dealing with diverse patient populations.

Wow. That was truly an eye-opening experience.

I cannot recommend this book highly enough to everyone. It offers a remarkable journey into the realm of better cross-cultural understanding.

This is especially relevant for those in the medical field.

The author has done an outstanding job of representing the two perspectives.

It shows that there isn't a simple binary of 'right' or 'wrong', 'good' or 'bad'.

Instead, there are just people, each with their own diverse beliefs.

They are all doing what they think is best based on their knowledge of the world.

This book provides a valuable and thought-provoking exploration of different cultures and how we can better understand and respect one another.

It is a wonderful recommendation from Joyan ❤️

This book was an absolute emotional rollercoaster for me. It tells the story of a real tragedy, a collision between two completely different systems and a spectacular culture clash. In the middle of it all is a little girl, Lia Lee, and everyone involved truly wants to do what's best for her. However, their efforts end up clashing and hurting everyone.

Everyone - and I mean everyone - just wants what's best for Lia. But unfortunately, nobody seems to be able to agree on what that actually is.

The book, written by Anne Fadiman after years of painstaking research and detailed interviews, focuses on Lia herself, her doctors, her parents, and the misunderstandings and tensions that arise. It also attempts to portray the Hmong culture to readers who may be unfamiliar with it.

Fadiman does her best to remain impartial and give everyone a chance to speak. But does she succeed? That's for the reader to decide. I think her heart lies with Lia's family, but she also reminds us not to dismiss the medical viewpoint too easily.

This is a story of real people, and it's very hard to talk about it as just a book. There was no malice or neglect, but when everything is put together, it becomes a tragedy fueled by cross-cultural misunderstanding.

I found it emotionally very hard to read, and it took me a long time to recover. I don't think I can assign a rating to this book because it felt like a gut punch to the soul. It's a good book, but don't expect to have a good time when you read it.

Recommended by: Left Coast Justin

This is an extremely serious book that is brimming with history, medical details, Hmong culture, and the politics of war and immigration in the United States. It serves as a rather condemnatory text, not only towards the U.S. in its international politics but also towards the rigidity of the American medical system.

Lia Lee is the 13th child of a Hmong couple from Laos. When the communists triumphed in Laos, the Hmong people, who had fought on the U.S. side during the war, were brutally killed, tortured, and starved. So, Lia's parents (Lia wasn't even born yet) bravely took their children and embarked on a perilous journey on foot to Thailand. They lived in a refugee camp there until they were granted permission to emigrate to the U.S. The culture shock they experienced was indescribable. Like many Hmong families, they ended up in Merced, CA, hoping to obtain a plot of land to farm, as that was what they were familiar with. However, they didn't get any land, and neither did most Hmong people. Lia's mother had to grow her plants and herbs in the parking lot of their apartment building.

Lia was born in a hospital in CA. (The other children had been born at home in Laos, caught by their mother's forearms to prevent them from touching the dirt floor, in complete silence so as not to wake the other children.) Lia seemed normal at first, but at around 8 months old, her sister slammed a door, and Lia had an epileptic seizure. American doctors understand this condition as a storm of electrical activity in the brain that causes seizures. The Hmong, on the other hand, view this condition as 'the spirit catches you and you fall down'. They believed that Lia's soul fled when she was frightened by the slamming door. They took her to the ER, and this was where the collision between the American doctors and Lia's parents, as well as the Hmong community, began. Because Lia's parents did not comply with the regimen of anti-convulsant meds, she was taken away from them when she was two and placed in foster care, upon the request of her doctor to the courts of CA. Even though she had great foster parents, I think this entire experience was extremely detrimental to Lia. She was returned to her parents before a year was up, and they gave her the prescribed meds, but Lia continued to get sicker. Eventually, she contracted sepsis and had seizures until she was essentially brain dead. Western medicine sent her home to die, expecting it to happen within hours or at most days. However, Lia did not die. Her parents took the most excellent and loving care of her. She was clean, fragrant, beautiful, and emotionally responsive to her parents. Her parents used herbal medicine that they knew from Laos and Hmong shamanistic healing ceremonies. That didn't mean Lia fully recovered, but she lived. The last scene where the chanter is calling her back is truly heartbreaking.

This book was of particular interest to me because I was epileptic as a child and also because I have a disabled child. I felt somewhat ashamed when reading about how Lia's parents took care of her. We do take good care of our son, but not as remarkably as her parents did. I thought I should make more of an effort. I also believe that there is a spiritual aspect to all of life. As long as we are alive on this earth, our body and soul cannot be separated or treated medically without considering the physical and spiritual aspects of a person. I think there is every possibility that both the western understanding of epilepsy and the Hmong understanding of epilepsy (if you are Hmong) are both true and not mutually exclusive. I was impressed with and interested in Hmong culture and looked up to see if there is a Hmong community here in Seattle. There is. It was also interesting to read about animal sacrifice in modern-day life. It's not the kind of warehouse killing but rather individual animals sacrificed in propitiation or thanks.

Altogether, this is an amazing book.

There are an abundance of valuable aspects within this book that it becomes extremely challenging to determine what to specifically mention.

Just having learned that Lia, the central figure of the book, passed away within the last week, I am compelled to express my utmost admiration to her family, and particularly her parents, for the unwavering love and care they provided for her throughout so many years.

Lia, along with a significant influx of Hmong, resided in Merced, CA when she had her first seizures. At that time, the Hmong, their language, and their culture were still virtually unknown and completely misunderstood in America. Meanwhile, Mia and her family were only familiar with their own culture and language. What follows is a sequence of missteps, errors, and, once again, misunderstandings.

This book offers an eye-opening account of multiculturalism, social services, and the medical community. There were and still are no straightforward answers, but there are always valuable lessons to be gleaned, and a great deal can be learned from this remarkable book.

I found it to be a truly fascinating read, written with great clarity. It is truly heartening to learn that this book is being utilized in educational settings. It is an absolute must-read for anyone working in a field that involves interaction with people of diverse cultures, as well as for the general lay reader.

It is very, very interesting indeed. However, it is slightly dated. And perhaps it might be a bit annoying if you are Hmong. There are lots of generalisations here. Although Fadiman does seem to know her stuff and does acknowledge her biases. For example, she talks at one point about romanticising the Hmong and so on. It is super sad lah. I was even angrier at the doctors than Fadiman was. I understand that it is very busy and stressful and all that in a hospital. But still, I thought their approach was incredibly shoddy. >:(

There is an interesting review by a Hmong reviewer. This review confirms my impression that Fadiman painted in rather broad strokes. And she had not altogether given up her habit of romanticising the Hmong. The link to the review is http://www.hmongnet.org/publications/...

Rarely do I encounter a piece of writing that has such a profound impact on both my heart and my brain. It is even rarer to find one that not only appeals to me but also challenges my thinking. It is truly astonishing that one single book could teach me more and evoke stronger emotions within me than any other. The term "tour de force" was indeed created for works of this caliber.

This book excels on multiple levels. Firstly, it serves as an excellent primer on how to organize vast amounts of information into a highly engaging and readable format. Secondly, it provides a fascinating introduction to Hmong culture, as well as an in-depth look at U.S. medical culture. Additionally, it offers perfect illustrations of the joys and sorrows of parenting, numerous examples of excellent expositional writing, and a captivating family saga. What else am I forgetting?

Doctor: "How long have you been having these headaches?"

Hmong patient, calmly: "Since I got shot in the head."

Surely, there is something else. Maybe it's the image of Hmong immigrants "hunting pigeons with crossbows in the streets of Philadelphia," or perhaps it's the final chapter, which elicited the strongest emotional response I've ever had to a book. Or maybe it's the social workers' assessment of the main family's parenting style as "high in delight." And let's not forget the horrific essays that the younger Hmong kids innocently submit to their shell-shocked Californian teachers. I could continue to list the many remarkable aspects of this book.

This is undoubtedly the best book I've ever read out of hundreds. Among all the books I hold dear, none can compare to this one. It is a true masterpiece that will stay with me for a long time.

Nowadays, in progressive medical education circles, when you mention the term “cultural competency,” you are often greeted with open contempt. I never truly grasped the reason for this until I read this book.

How could anyone, even after a lifetime of research, realistically expect to fully understand - to become competent in - a culture that is not their own?

If I were Lia Lee’s physician, even at my most empathetic, I would be at a loss as to how to start reconciling the Hmong view of disease with my own. I suppose one can only hope that if ever faced with a similar situation, one will have the humility to listen and respond to the patient's needs in a way that treats the pathology without neglecting the illness.

Moving beyond the medical realm, this book introduced me to a culture, a people, and a part of world history that I was entirely ignorant of. Fadiman’s masterful storytelling skillfully weaves anthropology, history, and narrative into a captivating thriller, ultimately leaving you with much more to contemplate than when you first began.

It makes you realize the importance of understanding different cultures in the medical field and beyond, and how much we still have to learn about the diverse world we live in.

If you are truly interested in learning about the Hmong people, it is advisable to look elsewhere.

This particular account unfortunately seems to have forgotten to shed its Eurocentric lens.

It fails to provide a comprehensive and accurate portrayal of the Hmong culture, traditions, and history.

Instead, it may be influenced by biases and limited perspectives that are rooted in a Eurocentric worldview.

To gain a more in-depth understanding of the Hmong people, one should seek out sources that are more culturally sensitive and inclusive.

These sources can offer a more nuanced and accurate picture of the Hmong way of life, their struggles, and their contributions to society.

By looking beyond the Eurocentric lens, we can open ourselves up to a more diverse and rich understanding of different cultures and peoples.

Anne Fadiman’s book, “The Spirit Catches You and You Fall Down” is truly a remarkable and deeply触动 story that has a profound impact on the heart.

As we delve into the medical issues surrounding Lia Lee, the writing skillfully addresses numerous sensitive subjects. One of the most alarming aspects is the vast cultural differences that exist.

Fadiman provides a necessary background by introducing readers to the Hmong culture, which has its roots mainly in southern China, Vietnam, Laos, Thailand, and Myanmar.

She vividly showcases the many disparities between their culture and the Western culture. Additionally, the way in which the Vietnam War scattered the Hmong is an important factor. Later on, the contradictions between our medical practices and the spiritual beliefs of the Hmong make the story an incredibly challenging yet captivating read. At various times, I found myself sympathizing with both the medical community and Lia’s family/community.

The book was written in the late 90s, and I sincerely hope that cultural awareness has been enhanced and is now being effectively utilized.

In general, this book is utterly fascinating, although I felt a great deal of pain for Lia, the patient who is the focus of the story.

It is a very detailed and engaging book that I wholeheartedly recommend to anyone with an interest in cultural anomalies.

This book was not my typical choice, but it turned out to be an absolute gem.

From the very first page, I was drawn into a world filled with complex characters and a captivating storyline.

The author's writing style was so engaging that I found myself completely immersed in the story, experiencing every emotion along with the characters.

It was a truly emotional journey that took me on a rollercoaster ride of feelings, from joy and excitement to sadness and heartbreak.

I was constantly on the edge of my seat, eager to find out what would happen next.

Despite not being my usual type of book, I found myself thoroughly enjoying this one and would highly recommend it to anyone looking for a great read.

It was a refreshing change of pace and a wonderful discovery that I will not soon forget.

Overall, I give this book a solid 4.5 out of 5 stars for its outstanding writing, engaging storyline, and emotional depth.

It is definitely a book that I will be thinking about for a long time to come.

In graduate school (comparative religion), I had the opportunity to take a class called ritual, illness, and the body. Just a few years after that, this remarkable book was published. Although we delved into other captivating examples of medical anthropology, particularly focusing on Western, especially American, practices, it would have been truly wonderful to have been able to incorporate this text into our studies.

Today, while doctors more frequently take courses in cross-cultural awareness during medical school, it still represents only a small fraction of their overall training, if they receive it at all. This book remains highly relevant even a couple of decades after its publication, not only to the medical community but to all of us. We all need to make greater progress in understanding the Other, whether we are part of the dominant culture or not. Fadiman expertly explicates the assumptions of the medical community as she endeavors (I'm certain her understanding only begins to scratch the surface of the Hmong worldview, no matter how hard she tried) to gain insights into traditional societies.

Beyond the tragic misunderstanding that led to the irreversible brain death of a beautiful Hmong child, there is much to contemplate here. I found myself thinking a great deal about the Amish, for instance, who have been permitted to live and believe as they wish. Yet, the Hmong asked for no more than some land of their own and the ability to continue living according to their beliefs. They fought bravely for us in Laos and became refugees due to the consequences of our policies in Indochina. They had no desire to assimilate into American culture. They did not come here for American opportunities but because they had nowhere else to go as a result of our actions. The only opportunity they found appealing about America was something they had heard about: Freedom. But they did not find it here. To them, it would mean the freedom to pursue their shamanic, agricultural, mountain lifestyle with its animistic beliefs and animal sacrifice. And if the Amish can do as they please, including being granted the right to be conscientious objectors in wars, why shouldn't these fighters be given the land they request and the freedom to follow their religion and lifestyle? It's just a question. Why indeed do we demand that ALL refugees merge into American society? Why can't it be a case-by-case basis? Some, like many Southern and Central Americans, come here seeking relief from the oppression in their own societies and the alternatives and opportunities offered by America, just as the ancestors of Euro-Americans did. Others come as a result of American policies abroad. It seems we should allow for these distinctions.

Fadiman does not directly pose this question. It is only implied.

Meanwhile, there are numerous other direct points about how collaborating with shamans and other native beliefs and family systems can assist families in agreeing to, for example, utilize Western medicine as well. And perhaps it can also help doctors be less dismissive of indigenous ways of perceiving things. The doctors in this California community tended to dismiss the Hmong, resourceful guerillas capable of withstanding large invading forces, as stupid and primitive. They also had no understanding of their traumatic pasts or how challenging it had been to adapt their highly adaptive skill set from their former land to things like apartment buildings and suburban lifestyles. Canned food, for instance. It wasn't that they were too stupid to figure it out, but rather that they were skeptical of its value, and in some ways, not too different from large groups of Americans who are increasingly reluctant to accept conventional Western medicine at face value.

Well written, moving, and definitely worth the read.